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December 1, 1961ThoraxOpen Access

The Surgical Treatment of the Tetralogy of Fallot

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CBC.N. BarnardSouthwestern Medical CenterVSV. SchrireSouth African Medical Research Council

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Overview

May refine clinical phenotyping of TOF and VSD with PS; leaves open validation in modern cohorts.

Key Points

  • To describe the continuous anatomical and hemodynamic spectrum linking ventricular septal defects and Tetralogy of Fallot resulting from bulbus cordis maldevelopment.
  • Characterized the pathological spectrum of right ventricular outflow tract obstruction combined with ventricular septal communication.
  • Analyzed hemodynamic shunt directions governed by the balance between pulmonary outflow stenosis and systemic vascular resistance.
  • Demonstrated that shunt direction depends directly on relative resistance: dominant left-to-right shunting occurs when systemic resistance exceeds pulmonary resistance, whereas right-to-left shunting (classic Tetralogy of Fallot) develops when pulmonary resistance is greater.
  • Identified that hemodynamics evolve dynamically over time, as hypertrophy of the crista supraventricularis leads to progressive infundibular narrowing and eventual right-to-left shunt reversal.

Cite This Study

Barnard et al. (1961) studied this question.

synapsesocial.com/papers/6a8667694c7902adb32fdf71https://doi.org/10.1136/thx.16.4.346
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Auscultatory and Phonocardiographic Assessment of Fallot's Tetralogy1960 · 36 citations
  2. 2THE SURGICAL TREATMENT OF MALFORMATIONS OF THE HEART1945 · 834 citations
  3. 3The Mechanics of Ventricular Contraction1951 · 131 citations
  4. 4Ventricular Septal Defect in Infants and Children1958 · 75 citations